Individual provider Active NPI

Angela Zaucha, FNP-BC

  • Family Nurse Practitioner
  • Midland, MI
National Provider Identifier
1376887471
Registry record updated Mar 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704203067 Issued in MI
Practice address
4011 Orchard Dr
Suite 1002
Midland, MI 48640-6190
Phone
(989) 794-5240
Fax
(989) 794-5230
NPI assigned
Nov 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704203067 MI Primary

Addresses

Primary practice location

4011 Orchard Dr
Suite 1002
Midland, MI 48640-6190

Mailing address

4011 Orchard Dr
Suite 1002
Midland, MI 48640-6190
Phone (989) 794-5240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260319000890 MI Order and Referring Only - Nurse Practitioner 2668607755

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704203067MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Midland PastSince Mar 14, 2016 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458172800000",
    "number": "1376887471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 ORCHARD DR",
            "address_2": "SUITE 1002",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406190",
            "telephone_number": "989-794-5240",
            "fax_number": "989-794-5230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 ORCHARD DR",
            "address_2": "SUITE 1002",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406190",
            "telephone_number": "989-794-5240",
            "fax_number": "989-794-5230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAUCHA",
        "first_name": "ANGELA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2016-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704203067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.